ORE Part 2 NHS Dental Contracts & Medical Emergencies 4 — Questions and Answers
Question 1: Under IRMER 2017 (Ionising Radiation Medical Exposure Regulations), what is the role of the 'referrer' in dental radiography?
- The registered dental professional who clinically justifies the need for the radiographic examination (Correct answer)
- The person operating the X-ray machine
- The dental nurse who positions the film
- The Radiation Protection Supervisor
Correct answer: The registered dental professional who clinically justifies the need for the radiographic examination
Under IRMER 2017, the referrer is the registered professional who requests or clinically justifies the radiographic examination; they must have adequate knowledge to justify the radiation exposure.
Question 2: What is the IRMER 2017 requirement for 'justification' of a dental radiograph?
- The benefit of the examination must outweigh the radiation risk to the individual (Correct answer)
- Any patient attending must be X-rayed
- Radiographs must be taken at every recall appointment
- Justification is only required for CBCT
Correct answer: The benefit of the examination must outweigh the radiation risk to the individual
IRMER 2017 requires that every individual radiographic examination is justified by demonstrating that the diagnostic benefit to the patient outweighs the radiation detriment, applying to all dental radiographs.
Question 3: What is the recommended recall interval for bitewing radiographs in a caries-free low-risk adult patient?
- Every 2 years (Correct answer)
- Every 6 months
- Annually
- Every 5 years
Correct answer: Every 2 years
FGDP(UK) radiographic guidelines recommend 2-yearly bitewing radiographs for low-risk adult patients with posterior tooth contacts and no recent caries, balancing diagnostic benefit against radiation dose.
Question 4: What is CBCT's primary advantage over conventional dental radiography?
- Three-dimensional imaging at lower dose than medical CT, showing structures in all planes without superimposition (Correct answer)
- Lower radiation dose than bitewing radiographs
- Better for detecting interproximal caries
- Equivalent to OPG in all situations
Correct answer: Three-dimensional imaging at lower dose than medical CT, showing structures in all planes without superimposition
CBCT provides volumetric 3D imaging, eliminating superimposition and allowing structures to be viewed in axial, coronal, and sagittal planes — invaluable for implant planning, impacted teeth, and jaw pathology.
Question 5: Which professional is designated as the 'Radiation Protection Supervisor' (RPS) in a dental practice?
- A named, trained member of the dental team responsible for day-to-day compliance with radiation procedures (Correct answer)
- Any dental nurse
- The practice owner only
- An external radiation physicist
Correct answer: A named, trained member of the dental team responsible for day-to-day compliance with radiation procedures
The RPS is a practice-based professional, trained in radiation protection, responsible for ensuring local rules are followed and day-to-day compliance with IRR 2017 radiation protection procedures.
Question 6: What are the three categories of individuals under IRMER 2017 involved in medical exposures?
- Referrer, Practitioner, and Operator (Correct answer)
- Patient, dentist, and nurse
- Employer, supervisor, and employee
- Radiographer, clinician, and patient
Correct answer: Referrer, Practitioner, and Operator
IRMER 2017 defines three duty holder categories for medical exposures: the Referrer (justifies/requests), the Practitioner (justifies/authorises), and the Operator (carries out the exposure practically).
ORE Part 2 NHS Dental Contracts & Medical Emergencies 4
Under IRMER 2017 (Ionising Radiation Medical Exposure Regulations), what is the role of the 'referrer' in dental radiography?